A GOOD AGE: Silencing the alarms in long-term care

Starting today, Newbridge on the Charles in Dedham is embarking on a promising and bold new venture in the care of its residents, many elderly. Bed and chair alarms may be phased out.

By Sue Scheible

The Patriot Ledger, Quincy, MA

By Sue Scheible

Posted May. 28, 2013 at 12:01 AM
Updated May 28, 2013 at 9:16 AM

By Sue Scheible

Posted May. 28, 2013 at 12:01 AM
Updated May 28, 2013 at 9:16 AM

» Social News

Starting today, Newbridge on the Charles in Dedham is embarking on a promising and bold new venture in the care of its residents, many elderly.

Most people have had the experience of visiting someone in a long-term-care residence and hearing repeated alarms go off when residents shift position in their wheelchairs or their beds, or a visitor sits on the edge of the bed. There are electronic sensors in the cushions or pads.

It is distracting, at the least, but the noise with its connotation of emergency can also raise anxiety levels, interfere with the sense of seeing someone in their “home,” and just enjoying a normal conversation or visit.

Those are some of the reasons why the Hebrew Rehabilitation Center is testing a program to phase out the use of the alarms. Instead, staff would use other ways of anticipating and keeping tabs on residents' safety.

In a May 22 letter to family members of residents at Newbridge, part of the Hebrew Rehabilitation Center, the reasons and plan are laid out. My brother, Steve, 71, who had a stroke, is a resident of the Gloria Adelson Field Health Center at Newbridge. His wheelchair seat cushion is alarmed.

The letter stated:

“As we move forward on our quest to create a home-like environment for our residents, we will be embarking on the goal of eliminating our bed and chair alarms in the hopes of providing a calmer and quieter environment, while increasing responses from staff to monitor our resident's safety.”

The letter noted that the Pioneer Network, a national organization which advocates for culture change in long-term care, strongly supports eliminating bed alarms. There is no clear evidence showing the alarms prevent falls. A team at Hebrew Rehabilitation Center has extensively researched the removal of bed alarms and found the alarms can actually increase the frequency of falls in elders, the letter said.

How could that be? Research found that the alarms have these negative effects on resident quality of life:

They create noise, fear and confusion. Residents with alarms tend to move and change position less, and that means they can become weaker and at more risk of falls, injury and skin breakdown. Alarms are embarrassing. They restrict freedom, dignity and privacy. They interrupt sleep. Residents can become incontinent. They alert staff only after someone has fallen. They trigger anxiety and distress in the residents who don't have them.

Page 2 of 2 - That’s quite a list of negatives. The team is evaluating how effective they are at Newbridge and looking at alternative ways to prevent falls by anticipating someone’s needs instead of reacting to the sound of an alarm.

The alarms will be removed from residents in one household at Newbridge and will not be issued to new residents. Instead, staff will make hourly rounds to check on residents in their rooms. When residents are sitting in the living room or at activities, they will be watched carefully. Every week for the next four months, June through September, the committee will review the rates of any falls.

If the results are positive, the other households at Newbridge will slowly be changed to the new model of care.

There will no doubt be lessons to be learned as well as some pleasant surprises. I credit Hebrew Senior Life for being open to innovative thinking. It takes time to make any major changes, but it is encouraging to see this quality of thinking and planning.

Reach Sue Scheible at scheible@ledger.com, 617-786-7044, or The Patriot Ledger, Box 699159, Quincy 02269-9159. Read her Good Age blog on our website. Follow her on Twitter @ sues_ledger. READ MOREGood Age columns.